Department of Gynecology and Obstetrics, Odense University Hospital, Institute of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Sdr, Boulevard, Odense, Denmark.
BMC Health Serv Res. 2012 Jun 21;12:168. doi: 10.1186/1472-6963-12-168.
Fragmentation in healthcare can present challenges for patients with suspected cancer. It can add to existing anxiety, fear, despair and confusion during disease trajectory. In some circumstances patients are offered help from an extra contact person, a Nurse Navigator (NN). Scientific studies showing who will benefit from the extra help offered are missing. This study aims to explore who could benefit from the help on offer from a nurse appointed as NN in the early part of a cancer trajectory, and what would be meaningful experiences in this context.
A longitudinal study with a basis in phenomenology and hermeneutics was performed among Danish women with gynecological cancer. Semi-structured interviews provided data for the analysis, and comprehensive understanding was arrived at by first adopting an open-minded approach to the transcripts and by working at three analytical levels.
Prior experience of trust, guarded trust or distrust of physicians in advance of encountering the NN was of importance in determining whether or not to accept help from the NN. For those lacking trust in physicians and without a close relationship to a healthcare professional, the NN offered a new trusting relationship and they felt reassured by her help.
Not everyone could use the help offered by the NN. This knowledge is vital both to healthcare practitioners and to administrators, who want to do their best for cancer patients but who are obliged to consider financial consequences. Moreover patients' guarded trust or distrust in physicians established prior to meeting the NN showed possible importance for choosing extra help from the NN. These findings suggest increased focus on patients' trust in healthcare professionals. How to find the most reliable method to identify those who can use the help is still a question for further debate and research.
医疗保健的碎片化可能会给疑似癌症患者带来挑战。它会在疾病发展过程中增加患者现有的焦虑、恐惧、绝望和困惑。在某些情况下，患者会得到额外联系人——护士导航员（NN）的帮助。目前缺乏关于哪些人将从额外的帮助中受益的科学研究。本研究旨在探讨在癌症发展早期，被指定为 NN 的护士提供的帮助对哪些人有益，以及在这种情况下哪些是有意义的体验。
在丹麦妇科癌症女性中进行了一项基于现象学和诠释学的纵向研究。半结构化访谈为分析提供了数据，通过首先对转录本采取开放的态度，并通过三个分析层面进行工作，达到了全面理解。
在遇到 NN 之前，对医生的信任、谨慎信任或不信任的先前经验对于是否接受 NN 的帮助至关重要。对于那些不信任医生且与医疗保健专业人员没有密切关系的人来说，NN 提供了一种新的信任关系，他们感到她的帮助让他们安心。
并非每个人都可以使用 NN 提供的帮助。这一知识对于医疗保健从业者和管理人员至关重要，他们希望为癌症患者提供最好的服务，但又必须考虑财务后果。此外，患者在遇到 NN 之前对医生的谨慎信任或不信任可能对选择 NN 的额外帮助具有重要意义。这些发现表明，应更加关注患者对医疗保健专业人员的信任。如何找到最可靠的方法来识别那些可以使用帮助的人，仍然是进一步辩论和研究的问题。
